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Portfolios are used in midwifery education to provide students with a central place to store their accumulative evidence of clinical experience for initial registration in Australia. Portfolio formats can be paper-based or electronic. Anecdotal discussion between midwifery students in Queensland debated the best format to document the requirements for the Australian Nursing and Midwifery Accreditation Council (ANMAC) standard 8.11. Midwifery students using paper-based portfolios envisioned that an ePortfolio would be streamline, simple, safe to use, and able to be used anywhere with WIFI, while some students using an ePortfolio expressed a desire to have a paper-based portfolio as a hard copy. This situation called for evidence of a comparison to resolve the debate. The aim of this study was to investigate midwifery students' experiences of the benefits and challenges between paper-based and ePortfolios when compiling evidence to meet the requirements for initial registration as a midwife in Australia (ANMAC, 2014). • Each type of portfolio had challenges and benefits. • Portfolio completion is time consuming, and stressful due to the need for verification of evidence. • Students require early and regular feedback on portfolio development. • National standards are required for consistency in documentation across universities. [ABSTRACT FROM AUTHOR]

(1) To describe facilitators and barriers to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food shopping via electronic benefits transfer (eWIC) compared with paper vouchers. (2) To explore suggestions that WIC participants had for modifying the program to enhance their overall WIC experience. Qualitative, semistructured, in-depth interviews. WIC participants in East Tennessee. Twenty-four primary food shoppers of WIC-participating households aged at least 18 years were recruited using a purposive sampling strategy. Perceived facilitators and barriers to use of eWIC as compared with paper vouchers. Interview transcripts were analyzed using a grounded theory approach to identify emergent themes. Participants identified several ways eWIC has improved their food shopping experience, including ad hoc redemption of WIC benefits and a quicker, more discrete checkout. Participants' chief complaint about eWIC was transaction errors at checkout. Participants identified other barriers to shopping for WIC foods that cannot be addressed by the card alone, such as difficulty identifying WIC items in-store. Participants reported changes to their benefit tracking behaviors and provided suggestions to improve WIC further. The transition to eWIC was viewed favorably among WIC participants, although participants identified a need for additional support in addressing transaction errors. This finding presents an opportunity to modify messages delivered to WIC participants by WIC nutrition educators and enhance collaboration between WIC agencies, retailers, and e-commerce technology providers. [ABSTRACT FROM AUTHOR]

Purpose To compare the Disabilities of the Arm, Shoulder, and Hand (DASH) patient-reported outcome measure as administered by tablet computer to the traditional paper format. Methods In a prospective, randomized study design, 223 consecutive adult patients who presented to the clinic of a single hand surgeon at a tertiary medical center were randomized by visit time to receive the DASH by either paper or tablet computer. Test completeness, time to completion, DASH score, and diagnostic and demographic data were collected and compared between the two cohorts. In total, 120 participants took the DASH using the tablet and 103 using paper. Results 43% of the paper surveys had at least one question that was omitted, compared with 13% in the tablet group; 14% of the paper surveys were not scoreable (< 27 questions answered) compared with 4% of the tablet surveys. The mean time to complete was 3.1 minutes for the paper version of the DASH and 4.3 minutes for the tablet version. Among our study population, there was no influence of age, sex, or diagnosis category on the time required to complete either version of the test. The mean DASH score was 45 for the paper version and 32 for the tablet version. Conclusions The use of digital data entry methods in the arena of health care outcomes research is increasing. Administration of the DASH via a tablet computer resulted in more complete data, slightly increased responder burden, and a lower DASH score. This finding may have important implications for the use of this metric in an electronic format in future research endeavors. Type of study/level of evidence Diagnostic II. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A large and increasing number of studies have reported a relationship between low nurse staffing levels and adverse outcomes, including higher mortality rates. Despite the evidence being extensive in size, and having been sometimes described as “compelling” and “overwhelming”, there are limitations that existing studies have not yet been able to address. One result of these weaknesses can be observed in the guidelines on safe staffing in acute hospital wards issued by the influential body that sets standards for the National Health Service in England, the National Institute for Health and Care Excellence, which concluded there is insufficient good quality evidence available to fully inform practice. In this paper we explore this apparent contradiction. After summarising the evidence review that informed the National Institute for Health and Care Excellence guideline on safe staffing and related evidence, we move on to discussing the complex challenges that arise when attempting to apply this evidence to practice. Among these, we introduce the concept of endogeneity, a form of bias in the estimation of causal effects. Although current evidence is broadly consistent with a cause and effect relationship, endogeneity means that estimates of the size of effect, essential for building an economic case, may be biased and in some cases qualitatively wrong. We expand on three limitations that are likely to lead to endogeneity in many previous studies: omitted variables, which refers to the absence of control for variables such as medical staffing and patient case mix; simultaneity, which occurs when the outcome can influence the level of staffing just as staffing influences outcome; and common-method variance, which may be present when both outcomes and staffing levels variables are derived from the same survey. Thus while current evidence is important and has influenced policy because it illustrates the potential risks and benefits associated with changes in nurse staffing, it may not provide operational solutions. We conclude by posing a series of questions about design and methods for future researchers who intend to further explore this complex relationship between nurse staffing levels and outcomes. These questions are intended to reflect on the potential added value of new research given what is already known, and to encourage those conducting research to take opportunities to produce research that fills gaps in the existing knowledge for practice. By doing this we hope that future studies can better quantify both the benefits and costs of changes in nurse staffing levels and, therefore, serve as a more useful tool for those delivering services. [ABSTRACT FROM AUTHOR]

Abstract: Internet based data collection methods have many advantages for psychological assessment when compared with more traditional paper formats, including, reduced costs, and greater convenience for both the researcher and the participant. However, prior to the wide-spread adoption of these methods, equivalence with paper tests formats must be established. The present study compared questionnaire data from the computer with that from a traditional paper format in a sample of college students both directly and through an opinion survey. Three types of questionnaires that represent distinct areas commonly assessed in psychological research included: quality of life (SF-36), depression (BDI-II) and personality (NEO). A within-subjects design counterbalanced order across the computer and paper formats. Overall the findings showed no differences for the Neuroticism and Extraversion facts of the NEO, for the BDI and for the subscales and composite scores of the SF-36. Significant differences were found between the paper and computer formats for the Openness, Agreeableness, and Conscientiousness facets of the NEO. Additionally, the computer was perceived to be convenient, user-friendly, comfortable, and secure. Results suggest that a computerized format is an efficient way to conduct quality of life research, especially for the assessment of distress levels and quality of life. [Copyright &y& Elsevier]

• Paper-based materials are cheap, non-polluting, and renewable, becoming hotspot materials. • The preparation method and application of superhydrophobic materials are introduced. • Analyzed the properties and application fields of superhydrophobic paper. • The preparation methods and application fields of superhydrophobic paper are summarized. • The prospects for the development of superhydrophobic paper are prospected. Inspired by natural animals and plants, people have successfully endowed various substrates with superhydrophobic properties using bionics principles, thus solving multiple scientific problems. Paper-based materials are cheap, renewable, and have great application value. Therefore, the paper has been widely studied in the superhydrophobic fields. The premise of industrial superhydrophobic materials is to put forward a green, efficient, and simple preparation method. Meanwhile, the prepared superhydrophobic paper must have excellent comprehensive properties. This paper briefly introduced the origin preparation methods and the applications of superhydrophobic materials; then emphatically summarized its preparation. Finally, the properties and application fields of superhydrophobic paper prepared by various methods were described, and the development has been prospected. [ABSTRACT FROM AUTHOR]

Abstract: Background: Paper based simulated patients are widely used to analyse nurses’ clinical judgements. However, developments in the physical simulation of clinical environments offer exciting, but relatively underexploited, opportunities for exploring nurses’ judgements. Critical event risk assessment is an element of acute care practice which lends itself well to simulation and in which more clinical experience is often assumed to lead to better quality judgements. Objectives: To model nurses’ judgements of critical event risk using physical and paper simulation and to examine whether improving fidelity via physical clinical simulation impacts on the apparent benefits of clinical experience on nurses’ judgement performance. Design: A comparative clinical judgement analysis. Setting: A university in Northern England. Methods: Sixty-three nursing students and 34 experienced nurses made dichotomous risk assessment judgements (“at risk” or “not at risk”) in response to 25 paper and physical simulated scenarios. These were randomly generated from a dataset of real patient case records. Clinical outcomes (the judgement criteria) for a ‘correct’ judgement were derived from the same case records. Logistic regression models were constructed to derive statistics for each nurse representing various measures of judgement performance: achievement (r a ), consistency (R s ) and clinical information use (G). These statistics were known as Lens Model statistics (from the psychological theory of Brunswik''s Lens Model of judgement). Performance measures for novice and experienced nurses were compared. Results: No significant differences in judgemental achievement (r a ) between experienced nurses and students were observed in either paper or high fidelity clinical simulations. Similarly, there were no significant differences in the nurses’ abilities to correctly match the ways they synthesised clinical information with the optimum synthesis required by the task (policy matching) (G). When faced with “paper patients” experienced nurses exercised more cognitive control/consistency (R s ) than students (P =0.04). However, this heightened control in experienced nurses was absent when those same nurses made judgements in the higher fidelity clinical simulation environment. Conclusion: Clinical experience made no difference to nurses’ judgement achievement (accuracy) in either the lower fidelity paper scenarios or the higher fidelity setting of the clinical simulation unit. The significant impact of clinical experience on judgement consistency was negated by the increases in fidelity offered through clinical simulation. [Copyright &y& Elsevier]

Background Context: Smartphone-based applications enable new prospects to monitor symptoms and assess functional outcome in patients with lumbar degenerative spinal disorders. However, little is known regarding patient acceptance and preference towards new modes of digital objective outcome assessment.Purpose: To assess patient preference of an objective smartphone-based outcome measure compared to conventional paper-based subjective methods of outcome assessment.Study Design: Prospective observational cohort study.Patient Sample: Fourty-nine consecutive patients undergoing surgery for lumbar degenerative spinal disorder.Outcome Measures: Patients completed a preference survey to assess different methods of outcome assessment. A 5-level Likert scale ranged from strong disagreement (2 points) over neutral (6 points) to strong agreement (10 points) was used.Methods: Patients self-determined their objective functional impairment using the 6-minute Walking Test application (6WT-app) and completed a set of paper-based patient-reported outcome measures (PROMs) before and 6 weeks after surgery. Patients were then asked to rate the methods of outcome assessment in terms of suitability, convenience, and responsiveness to their symptoms.Results: The majority of patients considered the 6WT-app a suitable instrument (median 8.0, interquartile range [IQR] 4.0). Patients found the 6WT more convenient (median 10.0, IQR 2.0) than the Zurich Claudication Questionnaire (ZCQ; median 8.0, IQR 4.0, p=.019) and Core Outcome Measure Index (COMI; median 8.0, IQR 4.0, p=.007). There was good agreement that the 6WT-app detects change in physical performance (8.0, IQR 4.0). 78 % of patients considered the 6WT superior in detecting differences in symptoms (vs. 22% for PROMs). Seventy-six percent of patients would select the 6WT over the other, 18% the ZCQ and 6% the COMI. Eighty-two percent of patients indicated their preference to use a smartphone app for the assessment and monitoring of their spine-related symptoms in the future.Conclusions: Patients included in this study favored the smartphone-based evaluation of objective functional impairment over paper-based PROMs. Involving patients more actively by means of digital technology may increase patient compliance and satisfaction as well as diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Many Dutch ecosystems, whether terrestrial, aquatic or sediment-based, are diffusely polluted by mixtures of contaminants, whose concentrations often exceed regulatory Safe Values or other generic quality criteria. This situation has unclear consequences, especially when local authorities are confronted with such pollution. Water managers are frequently in doubt whether their water systems satisfy the criteria for ‘Good Ecological Status’ as defined in the EU's Water Framework Directive. In case of soils, soil users may wonder whether the soil is ‘fit for use’. In case of nature conservation, the problem is that protected species might suffer from toxic stress. Official regulations in these cases call for appropriate action, but it is unclear whether the diffuse exposure causes adverse effects, and what the action should be. This paper proposes and discusses a site-oriented approach in the risk assessment of diffusely contaminated sites that can be used in addition to the compound-oriented policies from which the abovementioned generic quality criteria were derived. The site-oriented approach can be of help in reducing site-specific risks of diffuse contamination. Reflecting on the results of a large Dutch research effort in systems-oriented ecotoxicological effects, the conclusion is drawn that exposure and effects of diffuse pollution are site-specific in kind and magnitude, determined by the local combination of source–pathway–receptor issues, and often not clearly detectable (though often present). To assist in risk management, higher-tier methods can address various aspects, like addressing local mixture composition, bioavailability, and sensitivity of local species groups. Higher-tier risk assessment methods have as yet been developed mainly for cases of serious contamination, like for pesticide management and Risk-Based Land Management. For diffuse pollution, site-specific information can also be used to obtain site-specific exposure and impact information, while practical and ecology-based approaches can be introduced to obtain an integrated overview of the meaning of site contamination and to derive options for managing and reducing the local risks. These issues are discussed against the background of current major policy shifts, in The Netherlands and elsewhere, from a pollutant-oriented assessment to an additional ecological and site-oriented assessment. The latter is most clearly represented in the Good Ecological Status aim of the EU-Water Framework Directive. The paper assesses, integrates and discusses the results of the Dutch research effort in this policy context. [Copyright &y& Elsevier]

Background: In 2019, a randomized controlled trial (RCT) authored by Dr. Ismail was retracted due to concerns about data integrity. Since there are no policies in place to investigate other publications of authors of retracted studies, we investigated Dr. Ismail's other trials.Methods: We searched for RCTs authored by Dr. Ismail. We made pairwise comparisons of values in baseline and outcome tables between trials. We assessed whether the distributions of baseline characteristics were compatible with properly conducted randomization, using Monte Carlo simulations and the Kolmogorov-Smirnov test. We read the publications carefully for unusual features.Results: Dr. Ismail was author in eight published and one unpublished trial. In three of his first author studies we found multiple identical values in the baseline and/or outcome tables from different trials. At least some of the trials were unlikely to have followed a proper randomization process. There were a number of other unusual features in the papers we reviewed.Conclusions: It is probable that other trials published by Dr. Ismail contain questionable data. We call for a thorough investigation of the original trial data and related official documents. Our exercise suggests that the practice to assess research integrity should include all publications of authors with retracted fabricated articles. [ABSTRACT FROM AUTHOR]

While they account for one-fifth of new cancer cases, rare cancers are difficult to study. A higher than average degree of uncertainty should be accommodated for clinical as well as for population-based decision making. Rules of rational decision making in conditions of uncertainty should be rigorously followed and would need widely informative clinical trials. In principle, any piece of new evidence would need to be exploited in rare cancers. Methodologies to explicitly weigh and combine all the available evidence should be refined, and the Bayesian logic can be instrumental to this end. Likewise, Bayesian-design trials may help optimize the low number of patients liable to be enrolled in clinical studies on rare cancers, as well as adaptive trials in general, with their inherent potential of flexibility when properly applied. While clinical studies are the mainstay to test hypotheses, the potential of electronic patient records should be exploited to generate new hypotheses, to create external controls for future studies (when internal controls are unpractical), to study effectiveness of new treatments in real conditions. Framework study protocols in specific rare cancers to sequentially test sets of new agents, as from the early post-phase I development stage, should be encouraged. Also the compassionate and the off-label settings should be exploited to generate new evidence, and flexible regulatory innovations such as adaptive licensing could convey new agents early to rare cancer patients, while generating evidence. Though validation of surrogate end points is problematic in rare cancers, the use of an updated notion of tumor response may be of great value in the single patient to optimize the use of therapies, all the more the new ones. Disease-based communities, involving clinicians and patients, should be regularly consulted by regulatory bodies when setting their policies on drug approval and reimbursement in specific rare cancers. [ABSTRACT FROM AUTHOR]

This paper honours a paediatrician whose career has been patchwork but distinguished, with many facets. It is a light-hearted look at the printed (infinitely preferable to the electronic) word. Although the obvious response is "read everything I have written", this would only drive down the stores of Prozac. Read the scientific literature of course. The oldie reads to stay one jump ahead on the ward round. Meta-analyses and systematic reviews rely on the judgement of others, so should be regarded with suspicion. Do your own research, and do not rely on the thoughts of other people. Read beyond PubMed. "There is more in Heaven and Earth, Horatio, than is dreamed of in your PubMed" (Shakespeare). Read the giants of the past. Richard Asher has so much to teach. What are the seven sins of medicine, and how many have you committed? Asher is top read of the talk. Learn from the mistakes of the past. Your patient comes first. Read how the medical profession covered up the death of Steve Biko and never compromise with patient safety and your integrity. Finally, remember thou art mortal - read a real book for pleasure. Kindle reading must be like making love to an inflatable doll (not that I have done either). Choose what you relax with; for me, PG Wodehouse, Jane Austen, Billy Bunter and Wisden. Who said and why: 'Madam, under similar circumstances I would have kicked the Archangel Gabriel!'. [ABSTRACT FROM AUTHOR]

Thin layer chromatography (TLC) is a simple and inexpensive type of chromatography that is extensively used in forensic laboratories for drugs of abuse analysis. In this work, TLC is optimized to analyze cocaine and its adulterants (caffeine, benzocaine, lidocaine and phenacetin) in which the sensitivity (visual determination of LOD from 0.5 to 14mgmL(-1)) and the selectivity (from the study of three different eluents: CHCl3:CH3OH:HCOOHglacial (75:20:5v%), (C2H5)2O:CHCl3 (50:50v%) and CH3OH:NH4OH (100:1.5v%)) were evaluated. Aiming to improve these figures of merit, the TLC spots were identified and quantified (linearity with R(2)>0.98) by the paper spray ionization mass spectrometry (PS-MS), reaching now lower LOD values (>1.0μgmL(-1)). The method developed in this work open up perspective of enhancing the reliability of traditional and routine TLC analysis employed in the criminal expertise units. Higher sensitivity, selectivity and rapidity can be provided in forensic reports, besides the possibility of quantitative analysis. Due to the great simplicity, the PS(+)-MS technique can also be coupled directly to other separation techniques such as the paper chromatography and can still be used in analyses of LSD blotter, documents and synthetic drugs. [ABSTRACT FROM AUTHOR]

Writing and publishing scientific papers have become requisites for all scientists (researchers and academics alike) to maintain their professional career. The prospects of writing a scientific paper are often regarded as somewhat daunting to the uninitiated. However a universal, well established structure format known as "IMRAD": i.e. Introduction, Methods, Results And Discussion has been established. This paper details this methodology. [ABSTRACT FROM AUTHOR]

The Phadebas® Forensic Press Test is routinely used for the detection of saliva. However, assessment of the use of Phadebas® paper for this purpose has not been studied extensively. The suitability of Phadebas® paper as a presumptive screening tool for saliva on forensic exhibits, was investigated by analysing the following: (1) sensitivity, (2) specificity, (3) effects of temperature on sensitivity and specificity, (4) detection of saliva in mixed body fluid samples, and (5) influence of substrate porosity. The results of this study demonstrated that Phadebas® paper is more sensitive to α-amylase activity and less specific for saliva than previously reported. The use of an examination temperature of 37°C had no effect on sensitivity, but increased the incidence of cross-reactivity with other forensically relevant body fluid stains. Blood, urine and vaginal secretions can inhibit the detection of α-amylase activity with Phadebas® paper in mixed stains of saliva and body fluid. Substrate porosity is a weak predictor for the time taken for a saliva stain to achieve a strong positive result on Phadebas® paper. Overall, this study demonstrated that the Phadebas® Forensic Press Test has limitations as a presumptive test for the accurate identification of saliva. [ABSTRACT FROM AUTHOR]

Although the use of theories and evidence is often stressed in the development of health promotion interventions, this does not guarantee the success of an intervention. Thus, we need to reflect on intervention development processes that use different types of theories and evidence. In this paper, we provide a reflective discussion on how we identified evidence-based behavior change techniques and counseling themes for a health promotion intervention. In addition, we discuss the challenges that we encountered and what we learned during the process: a) a lack of previous research and meta-analyses, b) inconsistencies in evidence, c) integrating evidence and theories that have different starting points, and d) collaborating with researchers who represent different evidence and theories. During the process, we benefitted from having the clear goal of conducting evidence- and theory-based work. We solved the challenges by, for example, utilizing different types of evidence and being reflective about the reasons behind any inconsistencies in the evidence. In retrospect, we would have benefitted from closer collaboration between the teams that worked separately with different evidence. These kinds of reflective descriptions of development processes and the challenges encountered during them may help other researchers and professionals avoid encountering the same challenges. [ABSTRACT FROM AUTHOR]

Abstract: The three papers to follow, by Chris Rasmussen and three of his students, build from a task design the authors of this note developed in the 1990s. To introduce these papers, which extend our prior work in new directions, we sketch some background here. [Copyright &y& Elsevier]

Background: Electronic data collection is increasingly being used for discrete choice experiments (DCEs).Objectives: To study whether paper or electronic administration results in measurement effects.Methods: Respondents were drawn from the same sample frame (an Internet panel) and completed a nearly identical DCE survey either online or on paper during the same period. A DCE on preferences for basic health insurance served as a case study. We used panel mixed logit models for the analysis.Results: In total, 898 respondents completed the survey: 533 respondents completed the survey online, whereas 365 respondents returned the paper survey. There were no significant differences with respect to sociodemographic characteristics between the respondents in both samples. The median response time was shorter for the online sample than for the paper sample, and a smaller proportion of respondents from the online sample were satisfied with the number of choice sets. Although some willingness- to-pay estimates were higher for the online sample, the elicited preferences for basic health insurance characteristics were similar between both modes of administration.Conclusions: We find no indication that online surveys yield inferior results compared with paper-based surveys, whereas the price per respondent is lower for online surveys. Researchers might want to include fewer choice sets per respondent when collecting DCE data online. Because our findings are based on a nonrandomized DCE that covers one health domain only, research in other domains is needed to support our findings. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the measurement equivalence of individual response scale types by using a patient reported outcome measure (PROM) collected on paper and migrated into electronic format for use on the subject's own mobile device (BYOD) and on a provisioned device (site device).Methods: Subjects suffering from chronic health conditions causing daily pain or discomfort were invited to participate in this single-site, single visit, three-way crossover study. Association between individual item and instrument subscale scores was assessed by using the intraclass correlation coefficient (ICC) and its CI. Participant attitudes toward the use of BYOD in a clinical trial were assessed through use of a questionnaire.Results: In this study, 155 subjects (females 83 [54%]; males 72 [46%]) ages 19 to 69 years (mean ± SD: 48.6 ± 13.1) were recruited. High association between the modes of administration (paper, BYOD, site device) was shown with analysis of ICCs (0.79-0.98) for each response scale type, including visual analogue scale, numeric rating scale, verbal response scale, and Likert scale. Of the subjects, 94% (146 of 155) stated that they would definitely or probably be willing to download an app onto their own mobile device for a forthcoming clinical trial. Forty-five percent of subjects felt BYOD would be more convenient compared with 15% preferring a provisioned device (40% had no preference).Conclusions: This study provides strong evidence supporting the use of BYOD for PROM collection in terms of the conservation of instrument measurement equivalence across the most widely used response scale types, and high patient acceptance of the approach. [ABSTRACT FROM AUTHOR]

Context: Researchers administering surveys seek to balance data quality, sources of error, and practical concerns when selecting an administration mode. Rarely are decisions about survey administration based on the background of study participants, although socio-demographic characteristics like age, education, and race may contribute to participants' (non)responses.Objectives: In this study, we describe differences in paper- and web-based surveys administered in a national cancer survivor study of women with a history of cancer to compare the ability of each survey administrative mode to provide quality, generalizable data.Methods: We compared paper- and web-based survey data by socio-demographic characteristics of respondents, missing data rates, scores on primary outcome measure, and administrative costs and time using descriptive statistics, tests of mean group differences, and linear regression.Results: Our findings indicate that more potentially vulnerable patients preferred paper questionnaires and that data quality, responses, and costs significantly varied by mode and participants' demographic information. We provide targeted suggestions for researchers conducting survey research to reduce survey error and increase generalizability of study results to the patient population of interest.Conclusion: Researchers must carefully weigh the pros and cons of survey administration modes to ensure a representative sample and high-quality data. [ABSTRACT FROM AUTHOR]

Objective: Most preventable adverse drug events and medication errors occur during medication ordering. Medication order entry and clinical decision support are available on paper or as computerized systems. In this post-hoc analysis we investigated frequency and clinical impact of blood glucose (BG) documentation- and user-related calculation errors as well as workflow deviations in diabetes management. We aimed to compare a paper-based protocol to a computerized medication management system combined with clinical workflow and decision support.Methods: Seventy-nine hospitalized patients with type 2 diabetes mellitus were treated with an algorithm driven basal-bolus insulin regimen. BG measurements, which were the basis for insulin dose calculations, were manually entered either into the paper-based workflow protocol (PaperG: 37 patients) or into GlucoTab(®)-a mobile tablet PC based system (CompG: 42 patients). We used BG values from the laboratory information system as a reference. A workflow simulator was used to determine user calculation errors as well as workflow deviations and to estimate the effect of errors on insulin doses. The clinical impact of insulin dosing errors and workflow deviations on hypo- and hyperglycemia was investigated.Results: The BG documentation error rate was similar for PaperG (4.9%) and CompG group (4.0%). In PaperG group, 11.1% of manual insulin dose calculations were erroneous and the odds ratio (OR) of a hypoglycemic event following an insulin dosing error was 3.1 (95% CI: 1.4-6.8). The number of BG values influenced by insulin dosing errors was eightfold higher than in the CompG group. In the CompG group, workflow deviations occurred in 5.0% of the tasks which led to an increased likelihood of hyperglycemia, OR 2.2 (95% CI: 1.1-4.6).Discussion: Manual insulin dose calculations were the major source of error and had a particularly strong influence on hypoglycemia. By using GlucoTab(®), user calculation errors were entirely excluded. The immediate availability and automated handling of BG values from medical devices directly at the point of care has a high potential to reduce errors. Computerized systems facilitate the safe use of more complex insulin dosing algorithms without compromising usability. In CompG group, missed or delayed tasks had a significant effect on hyperglycemia, while in PaperG group insufficient precision of documentation times limited analysis. The use of old BG measurements was clinically less relevant.Conclusion: Insulin dosing errors and workflow deviations led to measurable changes in clinical outcome. Diabetes management systems including decision support should address nurses as well as physicians in a computerized way. Our analysis shows that such systems reduce the frequency of errors and therefore decrease the probability of hypo- and hyperglycemia. [ABSTRACT FROM AUTHOR]

Objective: Bleeding data in contraceptive trials are often collected using daily diaries, but data quality may vary due to compliance and recall bias. Text messaging is a widespread and promising modality for data collection.Study Design: This trial randomized participants 1:1 to use text messages or paper diaries to report on bleeding experienced during the 90 days after intrauterine device (IUD) insertion. Participants chose either the copper T380A or the 52-mg levonorgestrel IUD. Our primary outcome was number of days of reported bleeding data. We hypothesized that data gathered with daily text messages would have fewer missing values than paper diaries. Intention to treat analyses used the rank-sum test to compare medians.Results: Two hundred thirty women enrolled, and randomization yielded groups similar in baseline characteristics. Twenty percent of participants provided no bleeding data; of these, 77% were assigned to paper diaries. With 90 days of reporting, approximately 20% in each group provided complete bleeding data. The text group reported a median of 82 days [interquartile range (IQR) 40-89] and the paper group reported a median of 36 days (IQR 0-88) (p≤.001). The number of responses received decreased gradually over the 90-day period but was always higher in the text group. Women who had attained higher levels of education did well regardless of data collection modality, while response rates of text messages were greater among those with a high school education or less (p<.01).Conclusions: Participants reporting bleeding via text messages provided more complete data than women using paper diaries.Implications: Depending on resources and population of interest, text messages may be a useful modality to improve data collection for patient-reported outcomes. [ABSTRACT FROM AUTHOR]

Background: The adoption and use of health information technology (IT) continues to grow around the globe. In Switzerland, the government nor professional associations have to this day provided incentives for health IT adoption.Objective: We aim to assess the proportion of physicians who are routinely working with electronic health data and describe to what extent physicians exchange electronic health data with peers and other health care providers. Additionally, we aim to estimate the effect of physicians' attitude towards health IT on the adoption of electronic workflows.Methods: Between May and July 2013, we conducted a cross-sectional survey of 1200 practice based physicians in Switzerland. Respondents were asked to report on their technical means and where applicable their paper-based workarounds to process laboratory data, examination results, referral letters and physician's letters. Physicians' view of barriers and facilitators towards health IT use was determined by a composite score.Results: A response rate of 57.1% (n=685) was reached. The sample was considered to be representative for physicians in Swiss ambulatory care. 35.2% of the respondents documented patients' health status with the help of a longitudinal semi-structured electronic text record generated by one or more encounters in the practice. Depending on the task within a workflow, around 11-46% of the respondents stated to rely on electronic workflow practices to process laboratory and examination data and dispatch referral notes and physician's letters. The permanent use of electronic workflow processes was infrequent. Instead, respondents reported paper-based workarounds affecting specific tasks within a workflow. Physicians' attitude towards health IT was significantly associated with the adoption of electronic workflows (OR 1.04-1.31, p<0.05), but the effect sizes of factors related to the working environment (e.g., regional factors, medical specialty, type of practice) were larger.Conclusion: At present, only a few physicians in Swiss ambulatory care routinely work with electronic health data. Until more of their peers participate in electronic exchange of structured clinical information, most physicians will continue to stay in paper-based systems and workarounds. The survey found that physicians with a positive attitude towards health IT were more likely to adopt electronic workflows, but the impact is minor. It will likely be necessary to introduce financial incentives and develop national standards in order to promote the adoption by a critical mass of practicing clinicians. [ABSTRACT FROM AUTHOR]

The academic world revolves around research which is both a requisite to achieve a degree, as well as part of the job description of academics. Obtaining a research grant is often essential in order to cover the running costs of a research project. Once a research proposal has been formulated, with the help of supervisors/collaborators, both tangible costs and non-tangible costs can be calculated. These predicted values are essential when applying for a research grant. Different funding opportunities are available from different sources, often both local and international. The latter funding bodies are usually either dedicated to a specific disease or process. It is essential to identify the appropriate funding opportunity according to the funding body's priorities and guidelines so that the grant can then be accordingly formulated. The great majority of funding sources issue competitive calls, so the aim of your application is not to show that the researcher deserves funds, but why the study in question is the one most deserving of the limited funds available. In any funding application, the strengths of the individual researcher/research group and the relevance of the project itself are the main two selling points. However, without a well prepared management plan, applications flounder. This paper will outline how best to target and formulate this approach. [ABSTRACT FROM AUTHOR]

Background: Fermentation is a widely used method of natural food preservation that has consequences on the nutritional value of the transformed food. Fermented dairy products are increasingly investigated in view of their ability to exert health benefits beyond their nutritional qualities.Objective: To explore the mechanisms underpinning the health benefits of fermented dairy intake, the present study followed the effects of milk fermentation, from changes in the product metabolome to consequences on the human serum metabolome after its ingestion.Methods: A randomized crossover study design was conducted in 14 healthy men [mean age: 24.6 y; mean body mass index (in kg/m2): 21.8]. At the beginning of each test phase, serum samples were taken 6 h postprandially after the ingestion of 800 g of a nonfermented milk or a probiotic yogurt. During the 2-wk test phases, subjects consumed 400 g of the assigned test product daily (200 g, 2 times/d). Serum samples were taken from fasting participants at the end of each test phase. The serum metabolome was assessed through the use of LC-MS-based untargeted metabolomics.Results: Postprandial serum metabolomes after milk or yogurt intake could be differentiated [orthogonal projections to latent structures discriminant analysis (OPLS-DA) Q2 = 0.74]. Yogurt intake was characterized by higher concentrations of 7 free amino acids (including proline, P = 0.03), reduced concentrations of 5 bile acids (including glycocholic acid, P = 0.04), and modulation of 4 indole derivative compounds (including indole lactic acid, P = 0.01). Fasting serum samples after 2 wk of daily intake of milk or yogurt could also be differentiated based on their metabolic profiles (OPLS-DA Q2 = 0.56) and were discussed in light of the postprandial results.Conclusion: Metabolic pathways related to amino acids, indole derivatives, and bile acids were modulated in healthy men by the intake of yogurt. Further investigation to explore novel health effects of fermented dairy products is warranted.This trial was registered at clinicaltrials.gov as NCT02230345. [ABSTRACT FROM AUTHOR]

Objectives: A new patient-reported outcome (PRO) instrument to measure fatigue symptoms and impacts in relapsing multiple sclerosis (RMS) was developed in a qualitative stage, followed by psychometric validation and migration from paper to an electronic format.Methods: Adult patients with relapsing-remitting multiple sclerosis (RRMS) were interviewed to elicit fatigue-related symptoms and impacts. A draft questionnaire was debriefed in cognitive interviews with further RRMS patients, and revised. Content confirmation interviews were conducted with patients with progressive-relapsing multiple sclerosis (PRMS) and relapsing secondary-progressive multiple sclerosis (RSPMS). Psychometric analyses used data from adult patients with different RMS subtypes and matched non-RMS controls in a multicenter, observational study. After item reduction, the final instrument was migrated to a smartphone (eDiary) and usability was confirmed in interviews with additional adult RMS patients.Results: The qualitative stage included 37 RRMS, 5 PRMS, and 5 RSPMS patients. Saturation of concepts was reached during concept elicitation. Cognitive interviews confirmed that participants understood the instructions, items, and response options of the instrument-named FSIQ-RMS-as intended. Psychometric validation included 164 RMS and 74 control patients. Internal consistency and test-retest reliability were demonstrated. The symptoms domain discriminated along the RMS symptom-severity continuum and between patients and controls. Patients were able to attribute fatigue-related symptoms to RMS. Usability and conceptual equivalence of the eDiary were confirmed (n = 10 participants).Conclusions: With 7 symptom items and 13 impact items (in 3 impacts subdomains: physical, cognitive and emotional, and coping) after item reduction, the FSIQ-RMS is a comprehensive, valid, and reliable measure of fatigue-related symptoms and impacts in RMS patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of font size and paper thickness on the response to, and completion of, a self-completion postal questionnaire among older people with joint pain.Study Design and Setting: Randomized trial. People aged 50 years and older with joint pain who consulted a general practitioner at one of five general practices in Central Cheshire were sent a postal questionnaire. Questionnaire format (large or small font size, thick or thin paper) was randomly allocated using a 2 x 2 factorial design.Results: Questionnaires were received from 502 out of 650 participants (crude response 77%). Response was significantly higher for participants receiving questionnaires with a larger font size (79.3% vs. 75.2%; hazard ratio 1.26, 95% confidence interval: 1.02, 1.56). Paper thickness had no significant effect on response. Completion (measure by assessing double-page turnover error) was increased in participants receiving questionnaires printed on thicker paper (3.2% vs. 7.1%; P=0.049) but was not affected by font size.Conclusion: This study demonstrates that questionnaires in larger font and on thicker paper may produce higher and more complete responses than surveys using standard size font and standard thickness paper, and should therefore be considered in studies among older people. [ABSTRACT FROM AUTHOR]

Iron deficiency is the most common micronutrient deficiency worldwide, and transferrin receptor (TfR) level has been identified as an important measure of iron status that is not confounded by inflammation. However, logistical constraints associated with sample collection and processing have limited efforts to measure TfR, particularly at the community level. Standardized filter paper provides a relatively convenient and minimally invasive means for collecting and transporting samples of whole blood from simple finger pricks, and we present results of our validation of an improved method for quantifying TfR in dried blood spots. The method is based on commercially available reagents and uses capillary blood that is applied directly from the finger to filter paper, eliminating the need for premeasurement at the collection site. The blood spot TfR assay is precise and reliable, agrees well with plasma TfR, and can be performed at any facility with a microplate reader and basic laboratory equipment. Concentrations of TfR remain stable for at least 4 wk when blood spots are stored at room temperature, but begin to deteriorate after 3 d of exposure to higher temperatures. The advantages and disadvantages of the blood spot TfR method are discussed, as well as its potential contribution to future field-based studies of iron deficiency. [ABSTRACT FROM AUTHOR]

The detection and identification of body fluids at a crime scene shed light on the events which might have occurred and the people involved in the crime; the techniques used being lengthy, makes the on-scene detection a tough process to carry out and handle. This study aims to develop an on-spot detection method for serological testing using silica gel encapsulation technique and a modified microfluidic paper-based analytical device (μPADs). Kastle-Meyer reagent was incorporated into the μPAD and Silica Gel plate and was subsequently validated for the detection of blood. This study revealed that the μPAD was a better option. The emerging technique of μPADs allows a cost-effective and simple method of detection for body fluids. The fibrous network of the paper is manipulated to fabricate a guided channel for the fluid flow. The guided channels in the modified μPADs were fabricated by patterning a hydrophobic barrier out of wax. The analyte of interest for this study is blood but the principle can be modified to include other biological fluids. [ABSTRACT FROM AUTHOR]

Rationale and Objectives: The aims of this study were to label the versatile amino acid l-lysine with 99mTc using 2,3-dimercapto-succinic acid (DMSA) as a chelator, and to assess its tumor imaging feasibility under in vivo and in vitro conditions, and finally to determine the subcellular biodistribution of this radiopharmaceutical. Materials and Methods: DMSA-l-lysine was chemically synthesized and labeled with sodium pertechnetate. Nuclear magnetic resonance (NMR) and mass spectral analysis of DMSA-l-lysine were conducted. Radiochemical purity was determined by thin-layer chromatography (TLC) and paper chromatography. Cellular uptake, competition and subcellular localization studies were performed in rat breast cancer cells (13762). In vivo studies of planar imaging and biodistribution studies were performed on female Fischer 344 rats. Medical Internal Radiation Dose (MIRD) dosimetry estimates were calculated. Results: Radiochemical purity (determined by radio-TLC and high-performance liquid chromatography) of these compounds was >95%. 99mTc-DMSA-l-lysine showed good uptake in in vitro cell culture assays and uptake was reduced in competition studies. 99mTc-DMSA-l-lysine accumulates in the nucleus as much as in the cytoplasm and it was also shown that accumulation of the 99mTc-DMSA-l-lysine in the nucleus increases as a function of a time. There was an increase in tumor-to-blood and tumor-to-muscle count density ratios. Tumor/background ratios were 5.75 at 1 hour and 6.87 at 2 hours. In vivo tissue distribution studies revealed that radiation dosimetry of blood-forming organs were within radiation dose limits. Conclusion: DMSA-l-lysine kits can be labeled with 99mTc easily and efficiently, with high radiochemical purity and cost-effectiveness. In vitro cellular uptake and scintigraphic imaging studies demonstrated the pharmacokinetic distribution and feasibility of using 99mTc-DMSA-l-lysine for tumor imaging. [Copyright &y& Elsevier]

The article discusses the purpose of the discussion section of a scientific paper. It is noted that the discussion section provides the reader a summary of the main findings, comparing them with previous work and discussing future implications. Researchers are advised to start thinking about the discussion even prior to the collection of the first data.

We examine trends in words/terms published in Health & Place between 1995 and 2018. Terms used have diversified over this period, including a decline in 'health' overall, as well as greater usage of 'diet', 'alcohol' and 'depression'. There was a noticeable increase in using 'neighbourhood' to describe context. Topic modelling reveals that papers are increasingly concerned with specific aspects of place (e.g. the built environment). Our findings emphasise that Health & Place has matured into the leading outlet for examining the geographical dimensions of health with important and enduring insights that continue to inform research and policy. [ABSTRACT FROM AUTHOR]

Emergency contraception (EC) with 10 mg mifepristone can prevent pregnancy up to 5 days after a single act of unprotected intercourse. No methods have been shown to be effective when treatment is administered more than 5 days after a single unprotected act or after several unprotected acts. Therefore, we tested, among 699 Chinese women requesting EC and exposed to the risk of pregnancy described, the potential of 100 mg mifepristone followed 2 days later by 0.4 mg misoprostol orally, when administered in the luteal phase of the cycle. At the time of treatment urinary pregnancy test had to be negative. Despite treatment, 25 women (2.7%) became pregnant. Among women with treatment delayed more than 5 days, the pregnancy rate was related to the number of acts of intercourse before treatment, being 1.4% with one episode and increasing to 6.5% when the number of episodes was two or more (relative risk = 4.62, 95% CI: 1.06–20.18). Side effects within a week after treatment were mild, and most women (57.2%) had menstruation within 3 days as expected. An occasional treatment with mifepristone in combination with misoprostol could provide an option for preventing unwanted pregnancies in women who are late for EC. [Copyright &y& Elsevier]

Functional foods can be considered to be those whole, fortified, enriched or enhanced foods that provide health benefits beyond the provision of essential nutrients (e.g., vitamins and minerals), when they are consumed at efficacious levels as part of a varied diet on a regular basis. Linking the consumption of functional foods or food ingredients with health claims should be based on sound scientific evidence, with the "gold standard" being replicated, randomized, placebo-controlled, intervention trials in human subjects. However, not all foods on the market today that are claimed to be functional foods are supported by enough solid data to merit such claims. This review categorizes a variety of functional foods according to the type of evidence supporting their functionality, the strength of that evidence and the recommended intakes. Functional foods represent one of the most intensively investigated and widely promoted areas in the food and nutrition sciences today. However, it must be emphasized that these foods and ingredients are not magic bullets or panaceas for poor health habits. Diet is only one aspect of a comprehensive approach to good health. [ABSTRACT FROM AUTHOR]

Purpose: To report the histopathologic and ultrastructural features of three cases of interlenticular opacification (ILO) between piggyback intraocular lenses.Design: Interventional case series with clinicopathologic correlation.Methods: Three pairs of acrylic piggyback lenses were explanted due to decrease in visual acuity associated with ILO. Lenses were evaluated with gross and light microscopic examinations in all cases. The anterior lens in one case was examined with scanning electron microscopy and energy dispersive x-ray spectroscopy.Results: The material opacifying the interlenticular space was composed mostly of retained/regenerative cortical material in all cases. From the peripheral interface towards the central interface, the opacifying material changed as the interlenticular space was progressively narrower. The material attached to the peripheral interface, where the interlenticular space was wider, was very thick. At the midperipheral interface, the thick cortical material was broken into multiple globules due to liquefactive degeneration. At the paracentral zone, compression of the globules formed a flat, compact layer of an amorphous material. At the central interface (contact zone), almost no material could be found between the piggyback lenses.Conclusions: Analyses of ILO cases where all the components of the opacifying material were in situ allowed us to confirm that the pathogenesis of this complication is similar to that of posterior capsule opacification; thus, careful removal of lens epithelial cells and cortical material is mandatory in piggyback implantation. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tackling spatial inequalities needs to make sure that it improves the lives of people in rural and peripheral regions. Whilst local metrics and key indicators may be improved by measures implemented, this does not always translate to local people 'feeling' that development has improved their lives. Using ethnographic fieldwork and embodied and conversational research techniques, this paper adds to the place-based, evolutionary economic geography and resilience literature to develop the concept of the complex adaptive region assemblage, which draws on Deleuzian-based theory. I question whether this might be a lens to explore and better understand the measures that can be put in place in order to address the gap between regional development programmes, and the experiences of members of the public. The starting point was to explore the positionality of local people, and the paper finds that in the case studies (Cornwall UK and Southwest Virginia USA), systems put in place to revitalise these areas could be more effective if they pay attention to connecting spaces between local residents, and how they navigate their localities. • Place-based development needs to understand how local people experience rural regions. • Often, certain gaps make it more difficult for people to participate effectively in their regions. • Rural development needs to connect (missing) gaps in how people navigate place. • Viewing rural regions as complex adaptive assemblages helps to understand these gaps. [ABSTRACT FROM AUTHOR]

Methadone has several unique characteristics that make it an attractive option for pain relief in serious illness, but the safety of methadone has been called into question after reports of a disproportionate increase in opioid-induced deaths in recent years. The American Pain Society, College on Problems of Drug Dependence, and the Heart Rhythm Society collaborated to issue guidelines on best practices to maximize methadone safety and efficacy, but guidelines for the end-of-life scenario have not yet been developed. A panel of 15 interprofessional hospice and palliative care experts from the U.S. and Canada convened in February 2015 to evaluate the American Pain Society methadone recommendations for applicability in the hospice and palliative care setting. The goal was to develop guidelines for safe and effective management of methadone therapy in hospice and palliative care. This article represents the consensus opinion of the hospice and palliative care experts for methadone use at end of life, including guidance on appropriate candidates for methadone, detail in dosing, titration, and monitoring of patients' response to methadone therapy. [ABSTRACT FROM AUTHOR]

The development of technology creates a new concept in trading by combining real-time video with commercial activities known as live-streaming commerce. Livestreaming commerce or better known as shoppertaiment is a combination of electronic commerce and entertainment. The trend of shopping through livestreaming commerce is increasing, thus changing consumer habits and everyday lifestyles. Based on this situation, it is necessary to conduct research on livestreaming commerce. The aim of the research conducted is to consider the results of pre-existing studies and systematically review literature reviews on livestreaming commerce research by summarizing all academic scientific publication papers from 2017 to 2022. The research questions from this study were: (1) What are the current live-streaming commerce studies? (2) What research methods have been used in live-streaming commerce studies? (3) What are the potentials for future research on live-streaming commerce research? To answer the first question, various aspects of live streaming commerce are described, such as definitions, types, technologies, challenges, benefits, and models. Answer the second question by applying various methods and techniques. Finally, it offers guidelines for future research and makes this work a road map for understanding the live-streaming commerce research literature. [ABSTRACT FROM AUTHOR]

To describe the practical experience of delivering a proactive and integrated consultation-liaison (C-L) psychiatry service model (PICLP). PICLP is designed for older medical inpatients and is explicitly biopsychosocial and discharge-focused. In this paper we report: (a) observations on the training of 15 clinicians (seven senior C-L psychiatrists and eight assisting clinicians) to deliver PICLP; (b) the care they provided to 1359 patients; (c) their experiences of working in this new way. A mixed methods observational study using quantitative and qualitative data, collected prospectively over two years as part of The HOME Study (a randomized trial comparing PICLP with usual care). The clinicians were successfully trained to deliver PICLP according to the service manual. They proactively assessed all patients and found that most had multiple biopsychosocial problems impeding their timely discharge from hospital. They integrated with ward teams to provide a range of interventions aimed at addressing these problems. Delivering PICLP took a modest amount of clinical time, and the clinicians experienced it as both clinically valuable and professionally rewarding. The experience of delivering PICLP highlights the special role that C-L psychiatry clinicians, working in a proactive and integrated way, can play in medical care. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This classic methods paper () considers the assessment of agreement between measures, an often overlooked aspect of assessing measurements taken for use in research and practice and (re) introduces the ubiquitous ‘Bland Altman’ procedures for assessing agreement. The importance of these procedures is high and they address issues that are not always considered in research which uses measurement scales or describes the characteristics of scales developed for use in clinical practice. Many widely used approaches for reliability assessment can fail to consider the agreement between measures at all and can give an entirely misleading impression of an instrument's suitability for use in research or practice. [Copyright &y& Elsevier]

Floating bridges are economically attractive alternatives used for crossing wide and deep straits or fjords. They have played a crucial role in transportation since the early 20th century. Although several floating bridges are currently in operation worldwide, their design standards are not mature, especially associated with the dynamic response analysis. To this end, a review of the relevant advances and research directions of floating bridges is presented. In this paper, the development and types of floating bridges are briefly introduced. To evaluate the dynamic responses of floating bridges, research advances are reviewed from the perspectives of numerical simulations, model tests, and field measurements. It has shown that floating bridges are exposed to complex coastal environmental conditions in which combinations of various loads can induce significant load effects. Challenges can come from environmental inhomogeneity, structural flexibility, coupled effects, and multi-disasters. Besides, the existing research methods have more or less shortcomings, making it difficult to effectively analyze their dynamic responses. This paper summarizes the previous methods for the dynamic response analysis of floating bridges, with an emphasis on loads and load effects. Some recommendations and research opportunities for future work are also proposed. • Development and types of floating bridges are briefly summarized. • Relevant advances in design and analysis of floating bridges are reviewed. • Numerical simulations, model tests, and field measurements are addressed. • Challenges come from environmental modeling, load modeling, and response assessment. • Recommendations and research opportunities are identified. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effects of holding external loads on postural sway during upright stance across age decades. Sixty-five healthy adults (females, n = 35), aged 18-80 years were assessed in four conditions; (1) standing without holding a load, holding a load corresponding to 5% body mass in the (2) left hand, (3) right hand and (4) both hands. The centre of pressure (COP) path length and anteroposterior and mediolateral COP displacement were used to indirectly assess postural sway. External loading elicited reductions in COP measures of postural sway in older age groups only (P < 0.05). No changes were observed in younger or intermediate aged adults (P > 0.05). Holding external loads during standing is relevant to many activities of daily living (i.e. holding groceries). The reduction in postural sway may suggest this type of loading has a stabilising effect during quiet standing among older adults. [ABSTRACT FROM AUTHOR]